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Dry Needling

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Dry needling is a technique used to treat myofascial pain. It evolved after doctors discovered that whether they injected cortisone ,saline, dry injection or an acupuncture needle, the pain was relieved. This technique uses a “dry” needle and is inserted into the skin into the trigger point of the muscle. A trigger point is a discrete focal area within a muscle or its fascia where a hyperirritable knot or band develops and causes local or referred pain. Soft tissue painful,thickened areas, muscle knots, tension points  or post injury scarring respond well to this technique.

Stainless steel single use acupuncture needles of varying lengths and diameters, with rounded tips are used. The aim is to release or inactivate the trigger points, thereby relieving pain and improving range of motion. Research has shown that dry needling improves pain control, reduces muscle tension, and normalizes dysfunctions of the motor end plates, the sites at which nerve impulses are transmitted to muscles. This can help speed up the patient’s return to active rehabilitation. A good knowledge of anatomy is essential when dry needling, as is a sterile technique and correct disposal.

Craig Smith, from Club Physio runs  very comprehensive and enlightening dry needling courses.



On the Dry Needling Level 1 course, we covered 70%  of the bodies major muscles including the muscles of the buttocks, lower legs, upper limbs, Cervical and Lumbar spine and the shoulder girdle.

The Dry Needling Level 2 course includes the hands and feet, the abdomen, head and neck, and the thorax and pelvic area. It also covers clinical indications and how to manage various sports injuries, headaches, teninopathies and other common injuries that physios see .

After 3 days of having almost every muscle group needled, we left feeling more confident to use this technique in our practices, rather tired, but definitely with less aches and pains in our trigger points!

Thank you Craig!

dry needling



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Dr Raymond Perrin is an osteopath, neuroscientist and specialist in Chronic Fatigue Syndrome CFS/ME.
Club – Physio bought him out from the UK to share his 26 years of research on the subject.
An incredibly interesting, intelligent and entertaining lecturer, it was refreshing to hear his take on the subject, as it is an illness that is difficult to diagnose, understand and treat.


The sympathetic nervous system, receives messages from all over the body, including the lymphatic system, which helps rid the body of unwanted toxins. This drainage is helped along by the pressure of the blood vessels, which when not working correctly, causes the lymphatic vessels to become engorged especially in the head and neck area.His theory(and his research proves this), is that in patients with CFS/ME, the sympathetic nervous system has become overstrained, due to different stress factors either physical, allergies, infections or emotional stress. This is often due to a build up of toxins in the CSF(cerebral spinal fluid) around the brain and spinal cord and in these patients, the drainage into the lymph ducts along the spine and into the face and neck, are congested. The theory of the physiology is obviously a lot more complicated than that, but after years of research, he has developed a very concise questionnaire and assessment form, and discovered definite physical signs common to all CFS/ME sufferers, which then helps with a definite diagnosis.

The Perrin Technique is his treatment plan that he has developed and is an osteopathic approach using manipulation of the spine, craniosacral therapy and massage. This all helps to stimulate the fluid motion around the brain and spinal cord and help aid the drainage of the toxins out of the lymphatic system and into the blood, where they can be detoxified in the liver. As the body gets rid of the poisons, the sympathetic nervous system can begin to function correctly again.

The treatment has proved to be very successful, but it is no quick fix. This is a debilitating and complicated illness and patients are given an extensive home programme together with treatment by a registered practitioner, which can last up to 2 years.

Read more about his research on his website at

It was really inspiring to learn from the very passionate Dr Ray Perrin and find this great new evidence that can help diagnose and treat this very relatively unknown illness. I am certainly excited to try it out on those clients in need.


Podiatry and Orthotics

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I attended a lecture on podiatry and orthotics last night for physios by Sean Pincus.
It’s so important for the different disciplines to share their expertise so that we know when and where we should refer our patients onto someone else.
Podiatry deals with the foot in health and disease. Form dictates function, that is, the shape of the foot has a direct influence on how it functions. Incorrect form causes incorrect function and incorrect function becomes form.
So what are orthotics and when do we need them?

Orthotics are in-shoe devices that redirect force, redirect the joint axis and limit or enhance motion in order to correct foot function that has been identified as been an aetiology or detrimental to the overall foot and or body function.
In other words, when someone is complaining of continued foot and/or knee pain, excessive blistering, plantar fasciitis, stress fractures, bunions, sesamoiditis and is generally getting repeated injuries of the foot, knee, hip and the lower back and treatment is not helping, it may be time to get a podiatrist to assess the foot function and determine if the problems are arising from there.
A podiatrist will use specific video analysis of the gait and check hip, knee and lower back control. He will look at the shape of the foot, the movement of the foot in the sagital plane and the movements around the subtalar joint.  He will also asses the mechanism of the foot and any limb length discrepancies. Stress in the soft tissues can also cause repeated injuries.
A variety of materials are used to make orthotics depending on the problem. Rigid orthotic devices are typically made of plastic or carbon fibre, whereas soft orthotic devices are made of soft, compressible materials such as silicone or foam.



Foot pain can be very debilitating….they carry all our weight and we need them to be strong and healthy to keep us agile and grounded.
Foot dysfunction leads to many other aches and pains in the body so do not wait…get it checked out. (sais she, who on my off day decided to walk around the shopping centre in high heels as a change from my normal bare foot working day – the result….. very painful feet and very grumpy!)
Give Sean a visit if you are needing some help on the foot front. He has been around for many moons and knows his stuff.


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Not the usual physiotherapy course, I was very happy to get CPD points for attending something I am really interested in. And I was not disappointed. Presented by a fellow physio/alternate therapist, Ivo Visic guided us throught two days of mindfulness – an integrative approach to wellness. It always helps to have a presenter who walks his talk, has no ego and has done all the research. The course was stimulating, enlightening and fun and we all came away with another tool in our toolbox to share with our clients.

Mindfulness is the `in' thing at the moment, being taught in many health care professions and businesses all over ther world. It is nothing new though, being derived from the meditational practices from the Buddhist anapanasati, which has been around for thousands of years. Rather late than never though, mindfulness is maybe an easier way for us Westerners to learn the very powerful and useful art of meditating.

So what is Mindfulness? It is, simply put , ' paying attention on purpose, in the present moment, non judgementally as if your life depended on it.' This definition comes from Jon Kabat - Zinn, creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine. The foundations of Mindfulness are non-judging, patience, trust, acceptance and letting go. These are the qualities we try to develop by practising Mindfulness, the challenge then being to apply these to everything we do in our lives. Certainly not an easy task, but worth a try. Practising Mindfulness teaches us to pay attention, and this then helps us to become more emotionally and cognitively flexible, which helps us to be aware without judgement, which results in mental and physical wellbeing. Awareness helps us to change deeply ingrained habits, change old behaviours and establish new ones, i.e. we can change the way we think, speak and behave. It requires compliance, that is, alot of practise and comittment.The reward is ahost of new, stabilizing, self-calming behaviours. The research is there and is coming in fast and furiously(Kabat-Zinn),claiming usefulness in treating chronic pain,anxiety,depression, fibromyalgia,substance abuse, headaches and a host of other lifestyle-related illnesses we all seem to suffer from.

To begin, we need to be mindful of the breath. In a comfortable position and posture, we begin to pay attention to the breath. We try not to think about it, but when the thoughts come, we notice them and then try to go back to the breath.Our focus is not too loose and not too tense. Sighing is a good way to help us to relax and start. That's the first exercise. Just sitting and being still, mindful of the breath. We did many more throughout the weekend – The Inner Smile Practice, Body Scan and Dialoguing, Somatic Integration and then using Mindfulness in our Postures, in Movement and in our own Presence as Practioners.

It was a wonderful, mindful weekend. I would highly recommend Ivo`s course for anyone,not only health care practioners. It is a very useful tool for all of us, and I plan to pass it on to my clients. Follow Ivo on

Thank you Craig from for providing yet another great course.              



CPR course: Basic Life Support For Healthcare Providers

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Last week I attended a CPR course, Basic Life Support For Healthcare Providers, as part of our obligatory CPD points we have to get every year as a Physio.

I haven’t done a CPR course in years and so it was most enlightening. It was run by a wonderfully, enthusiastic woman from the Resuscitation Council of South Africa and I would highly recommend anyone to do it.

So here it is in a nutshell.

Assess the scene and make sure its safe for you and the victim

Tap the victims shoulder and ask them if they are alright. Check so see if they are breathing. If not, shout for help or phone the emergency number – toll free number is 10177 and 112 from a cell phone.

Check for a pulse at the carotid artery and if none is found, start compressions.

Its not ABC anymore, but CAB. Chest compressions now come first and should be started within 10 seconds of recognition of cardiac arrest.

Kneel at the victims side. Put the heel of one hand on the centre of the chest on the lower half of the breastbone. Put the heel of your other hand on top of the first hand.

Push hard and push fast at a rate of at least 100/min with a depth of at least 5cm for adults and children and 4cm for infants. Allow complete chest recoil after each compression. Tilt the head back and lift the jaw to bring the chin forward, thereby opening the airway. It is suggested that a barrier device is used when giving breaths, such as a face mask, but sadly, I don’t think most of us carry those in our handbags(which we probably should do). Give effective breaths that make the chest rise.

If you are on your own or there are 2 of you, do 30 compressions to 2 breaths for an adult.  For an infant,30 to 2 if you are on your own and 15 to 2 if there are two of you.

There`s a lot more, so get together with a few friends and do the course.

I really think it is something we should all be confident and efficient in doing.